“Observe your thoughts,don’t believe them”
Eckhart Tolle
High value
1.Pacemaker & Defibrillator
2.Heparin in Acute coronary syndrome
3.Diuretic therapy for cardiac failure & pulmonary edema
Low value
1.PCI> 24 hrs after STEMI
2.Most CTO Interventions
3.AF ablation
Strong contenders for high value Interventions
1.PTMC
2.Thrombolysis & DAPT
3.Diet and excercise modulation
Strong contenders for low Value Intervention
1.TAVI in young & SAVR eligible population
2.Mitra clip
3.LAA appendage closure
Final message
Unfortunately, most of us are blinded (artificially though!) to quality check , outcome assessment, & comparative effectiveness with already available treatment modalities.Every cardiologist shall create their own value based list of intervention according to their conscience, and stick it on the consultation table as a ready recokner.
Counterpoint
Value is a subjective concept that can be challenging to define precisely. It may not always apply equally to every individual.Ideally, population based value assessment should give us the true value. Reality is different. In some cases, what may seem like nonsense to others can hold significant value for a particular person. This highlights the importance of recognizing diverse perspectives.
Dr.S.Venkatesan MD 